Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4453
Peer-review started: February 19, 2021
First decision: March 7, 2021
Revised: March 7, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: June 16, 2021
Processing time: 99 Days and 2.3 Hours
Schwannoma of the pancreas is extremely rare. We report a case of pancreatic schwannoma that was difficult to distinguish from pancreatic carcinoma before surgery.
A 66-year-old male underwent a right-lobe hepatectomy for hepatocellular carcinoma. Post-surgical computed tomography showed a 10 mm long solid mass with ischemia, with no expansion into the main pancreatic duct. Upon magnetic resonance cholangiopancreatography, the tumor had high signal intensity in diffusion weighted images, consistent with pancreatic carcinoma. Endoscopic ultrasound (EUS) was performed to obtain more information about the tumor, and showed a 14 mm solid and hypoechoic mass in the pancreatic body. Contrast enhanced EUS revealed that the tumor showed a hyperechoic mass in the early phase, and the contrasting effect continuation was very short; findings also consistent with pancreatic carcinoma. Thus, we preoperatively diagnosed his condition as a pancreatic carcinoma and performed distal pancreatectomy with splenectomy. Microscopic examination showed that the tumor was in fact a benign schwannoma. Histology showed a proliferation of spindle-shaped cell in a vague fascicular and haphazard pattern, with palisading arrangement.
Schwannoma of the pancreas is very rare, however, clinicians should consider schwannoma as the differential diagnosis for pancreatic tumors.
Core Tip: Schwannoma of the pancreas is extremely rare, with 68 cases reported in the literature. On the other hand, preoperative diagnosis of schwannomas can be difficult, as schwannomas have no specific imaging findings, thus the preoperative diagnosis is not easy to confirm. We have experienced a case of schwannoma in pancreatic body mimicking pancreatic carcinoma, and performed surgical treatment. Clinicians should consider nonepithelial tumors as a part of the differential diagnosis for pancreatic tumors despite their low frequency.